HYPOPHYSIS CEREBR1 343 



absence of menstruation in women, and sterility in both the male 

 and the female, are among the clinical symptoms of gigantism. 

 In rare cases, a preceding stage of sexual hyperactivity has been 

 observed (Buday and Jancso). In contrast to the other internal 

 organs, which show hyperplasia, the sexual glands are usually 

 atrophied with signs of degenerative lesion. The secondary 

 genital organs and genital excretory ducts (prostate and penis, 

 uterus and vagina) are also, as a rule, remarkably defective in 

 development, and signs of infantilism are by no means infrequent. 

 Lack of intelligence; mental apathy and indolence; lack of mus- 

 cular tone and power; poorness of hair all over the body, 

 especially that of the pubes, axillse, and in the male, of the beard ; 

 and, in many cases, excessive development of the panniculus 

 adiposus these are all signs that the organism has remained at 

 an infantile stage of its development. The slight powers of 

 resistance of the subjects of gigantism is shown by the fact that 

 they usually die at an early age as the result of accidental illness. 

 Those cases of gigantism which pass on into definite acromegaly 

 are the only ones which offer a better prognosis concerning the 

 duration of life. The anomalies of metabolism are, as yet, unin- 

 vestigated. The comparatively frequent occurrence of glycosuria 

 or even of serious diabetes, is worthy of remark. 



The pathogenesis of gigantism was first discussed by Pierre 

 Marie in the course of his investigations into the nature of 

 acromegaly. Marie believes that true gigantism is characterized 

 by an excessive increase of all the processes of normal bony 

 growth ; and that it is to be distinguished from those cases of 

 symptomatic gigantism in which there is abnormal growth of 

 certain portions only, as, for instance, in acromegaly, elephanti- 

 asis, and certain forms of congenital syphilis. 



The similarity between certain of the symptoms in gigantism 

 and in acromegaly especially the enlargement of the sella turcica 

 as seen in museum specimens together with the fact that the 

 subjects of gigantism frequently develop the typical signs of 

 acromegaly, led many authors to dispute this theory of Marie's. 

 Brissaud and Meige adopted the view, based upon the relation- 

 ship between acromegaly and gigantism, that the conditions both 

 originate in the same pathological processes, and that they differ 

 from one another only in the moment at which the pathological 

 process takes place. According to Brissaud, gigantism is the 

 acromegaly of the period of growth, acromegaly the gigantism 

 of the adult stage ; and acromegalic gigantism is the result of a 

 pathological process, which commences during the period of 

 growth and continues on into the period in which growth has 

 ceased. 



This theory received valuable support from the exhaustive 

 investigations of Launois and Roy. These authors also dis- 

 tinguished between two forms of gigantism, the acromegalic and 



